Interspinous spacer and methods and systems utilizing the interspinous spacer

An interspinous spacer that includes a body having a distal portion and a proximal portion; an actuator at least partially disposed in the body; and a first arm and a second arm, where the first and second arms are rotatably coupled to a distal portion of the body and coupled to the actuator, where the actuator, first arm, and second arm are configured, upon rotation of the actuator in a first direction, to move the first and second arms from an implantation position, in which the first and second arms extend from the distal portion of the body back toward the proximal portion of the body, to a deployed position, in which the first and second arms extend away from the body.

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Description
CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No. 63/310,449, filed Feb. 15, 2022, which is incorporated herein by reference.

FIELD

The present invention is directed to the area of interspinous spacers for deployment between adjacent spinous processes. The present invention is also directed to systems and methods for utilizing the interspinous spacer.

BACKGROUND

With spinal stenosis, the spinal canal narrows and pinches the spinal cord and nerves, causing pain in the back and legs. Typically, with age, a person's ligaments may thicken, intervertebral discs may deteriorate, or facet joints may break down. The conditions can contribute to the narrowing of the spinal canal. Injury, heredity, arthritis, changes in blood flow, and other causes may also contribute to spinal stenosis.

Various treatments of the spine have been proposed or used including medications, surgical techniques, and implantable devices that alleviate and substantially reduce pain associated with the back. In one surgical technique, a spacer is implanted between adjacent spinous processes of a patient's spine. The implanted spacer opens the spinal canal, maintains the desired distance between vertebral body segments, and, as a result, avoids or reduces impingement of nerves and relieves pain. For suitable candidates, an implantable interspinous spacer may provide significant benefits in terms of pain relief.

Any surgery is an ordeal. However, the type of device and how it is implanted has an impact. For example, considerations when performing surgery to implant an interspinous spacer include the arrangement of the device and the possibility of damaging bone or tissue.

BRIEF SUMMARY

One aspect is an interspinous spacer that includes a body having a distal portion and a proximal portion; an actuator at least partially disposed in the body; and a first arm and a second arm, where the first and second arms are rotatably coupled to a distal portion of the body and coupled to the actuator, where the actuator, first arm, and second arm are configured, upon rotation of the actuator in a first direction, to move the first and second arms from an implantation position, in which the first and second arms extend from the distal portion of the body back toward the proximal portion of the body, to a deployed position, in which the first and second arms extend away from the body.

In at least some aspects, the body includes a cup and a casing attached to the cup, wherein the actuator includes a head disposed in the cup and a shaft attached to the head and extending through the casing. In at least some aspects, each of the first arm and the second arm are configured for rotation of at least 90 degrees. In at least some aspects, the actuator and each of the first arm and the second arm are configured for rotation in a first direction and then rotation in a second direction opposite the first direction.

In at least some aspects, the interspinous spacer further includes an actuator retainer attached to an end of the shaft of the actuator outside of the casing. In at least some aspects, the head of the actuator includes a shaped cavity configured to receive a shaped spacer engaging bit of a driving tool for rotating the actuator. In at least some aspects, a least a portion of the shaft of the actuator includes threading. In at least some aspects, each of the first arm and the second arm includes an attachment portion with a threaded surface configured for engagement with the threading of the shaft of the actuator. In at least some aspects, each of the attachment portions further includes at least one end stop bounding the threaded surface to resist further rotation of the respective first or second arm. In at least some aspects, at least one of the threading of the shaft of the actuator or the threaded surfaces of the attachment portions of the first and second arms have a mechanical ratio of at least 10:1.

In at least some aspects, the interspinous spacer further includes a first pin rotatably coupling the first arm to the body and a second pin rotatably coupling the second arm to the body. In at least some aspects, the first pin and the second pin are self-locking pins.

Another aspect is a method of using any of the interspinous spacers. The method includes releasably coupling the interspinous spacer in the implantation position to a spacer insertion instrument; inserting the interspinous spacer coupled to the spacer insertion instrument into a patient and between a pair of adjacent spinous processes; rotating the actuator of the interspinous spacer using a driver tool to deploy the first and second arms to the deployed position with each of the arms seating a different one of the adjacent spinous processes; releasing the interspinous spacer from the spacer insertion instrument; and removing the spacer insertion instrument.

A further aspect is an interspinous spacer that includes a body having a distal portion and a proximal portion; an actuator at least partially disposed in the body; and a first arm and a second arm, where the first and second arms are rotatably coupled to the body and coupled to the actuator, where the actuator, first arm, and second arm are configured, upon rotation of the actuator in a first direction, to rotate the first and second arms from an implantation position, in which the first and second arms are disposed adjacent to the body along a majority of a length of each of the first and second arms, to a deployed position, in which the first and second arms extend away from the body.

In at least some aspects, the body includes a cup and a casing attached to the cup, wherein the actuator includes a head disposed in the cup and a shaft attached to the head and extending through the casing. In at least some aspects, the head of the actuator includes a shaped cavity configured to receive a shaped spacer engaging bit of a driving tool for rotating the actuator, wherein a least a portion of the shaft of the actuator includes threading. In at least some aspects, each of the first arm and the second arm includes an attachment portion with a threaded surface configured for engagement with the threading of the shaft of the actuator. In at least some aspects, at least one of the threading of the shaft of the actuator or the threaded surfaces of the attachment portions of the first and second arms have a mechanical ratio of at least 10:1.

Yet another aspect is a method of using any of the interspinous spacers. The method includes releasably coupling the interspinous spacer in the implantation position to a spacer insertion instrument; inserting the interspinous spacer coupled to the spacer insertion instrument into a patient and between a pair of adjacent spinous processes; rotating the actuator of the interspinous spacer using a driver tool to rotate the first and second arms from an implantation position, in which the first and second arms are disposed adjacent to the body along a majority of a length of each of the first and second arms, to a deployed position, in which the first and second arms extend away from the body; releasing the interspinous spacer from the spacer insertion instrument; and removing the spacer insertion instrument.

A further aspect is a kit that includes any of the interspinous spacers; a spacer insertion instrument configured to releasably grip the interspinous spacer for implantation into a patient; and a driver tool including a spacer engaging bit configured to engage the actuator of the interspinous spacer and rotate the actuator by rotation of the driver tool.

BRIEF DESCRIPTION OF THE DRAWINGS

Non-limiting and non-exhaustive embodiments of the present invention are described with reference to the following drawings. In the drawings, like reference numerals refer to like parts throughout the various figures unless otherwise specified.

For a better understanding of the present invention, reference will be made to the following Detailed Description, which is to be read in association with the accompanying drawings, wherein:

FIG. 1 is a schematic perspective view of one embodiment of an interspinous spacer in an implantation or undeployed position;

FIG. 2 is a schematic perspective view of the interspinous spacer of FIG. 1 in a partially deployed position;

FIG. 3 is a schematic perspective view of the interspinous spacer of FIG. 1 in a deployed position;

FIG. 4 is a top view of the interspinous spacer of FIG. 1;

FIG. 5 is a cross-sectional view of at least a portion of the interspinous spacer of FIG. 1;

FIG. 6 is an exploded view of the interspinous spacer of FIG. 1;

FIG. 7 is a perspective view of one embodiment of a spacer insertion instrument; and

FIG. 8 is a perspective view of one embodiment of a driver tool.

 DETAILED DESCRIPTION

The present invention is directed to the area of interspinous spacers for deployment between adjacent spinous processes. The present invention is also directed to systems and methods for utilizing the interspinous spacer.

Examples of interspinous spacers are found in U.S. Pat. Nos. 8,123,782; 8,128,662; 8,273,108; 8,277,488; 8,292,922; 8,425,559; 8,613,747; 8,864,828; 9,119,680; 9,155,572; 9,161,783; 9,393,055; 9,532,812; 9,572,603; 9,861,398; 9,956,011; 10,080,587; 10,166,047; 10,610,267; 10,653,456; 10,835,295; 10,835,297; 11,013,539; and 11,229,461, all of which are incorporated herein by reference. (Unless indicated otherwise, the features and methods described in these references can be applied to the interspinous spacers described herein.) In these spacers, the arms typically extend away from the body of the spacer when the spacer is in the implantation position. In these spacers, the arms typically lead the remainder of the spacer when inserted into the body of the patient. During deployment, the arms back toward the body of the spacer and rotate away from the spinal cord to finally be disposed around the adjacent spinous processes.

In contrast, a spacer can include arms that are disposed adjacent the body and extend from the distal portion of the body of the spacer back toward the proximal portion of the body of the spacer when in the implantation position and during implantation. In at least some embodiments, the arms are disposed adjacent to the body along a majority of a length of each of the first and second arms. In at least some embodiments, an end (which may be relatively blunt) of the body of the spacer leads when the spacer is inserted into the body of the patient. In at least some embodiments, leading with a blunt end of the spacer can reduce any likelihood of cutting into bone, ligaments, or other tissue. During deployment, the arms of these spacers rotate in a direction toward the spinal cord and away from the body of the spacer to be finally disposed around the adjacent spinous processes. In at least some embodiments, rotating the arms toward the spinal cord may reduce any likelihood of catching the arms on the spinous processes prior to full deployment.

FIG. 1 illustrates one embodiment of an interspinous spacer 100 that includes a body 102, a first (or superior) arm 104, a second (or inferior) arm 106, and an actuator 108. The body includes a distal portion 102a and a proximal portion 102b. The actuator 108 is at least partially disposed in the body 102 and extends from the distal portion 102a of the body to the proximal portion 102b of the body. The first and second arms 104, 106 are coupled to the distal portion 102a of the body 102 and coupled to the actuator 108 for rotation of the arms as described below.

In FIG. 1, the spacer 100 is in the implantation position (e.g., undeployed position) with the arms 104, 106 extending from the distal portion 102a of the body back toward the proximal portion 102b of the body and disposed adjacent to the body 102 along at least a majority of the length of the arms, instead of extending away from the body. In FIG. 2, the arms 104, 106 of the spacer 100 are partially deployed and in FIG. 3 the arms 104, 106 are in the deployed position with the arms 104, 106 extending away from the body 102. FIG. 4 is a top view of the spacer, FIG. 5 is a cross-sectional view of at least a portion of the spacer 100, and FIG. 6 is an exploded view of the spacer 100.

Turning to FIG. 6, the actuator 108 includes a head 110, a shaft 112 with threads 114 extending along a least a portion of the shaft, and a collar 111 (FIG. 5) and flange 113 (FIG. 5) disposed at an end of the actuator opposite the head. The head 110 of the actuator 108 includes a shaped cavity 116 to receive a driver tool 880 (FIG. 8) with a complementary shaped spacer engaging bit 884. The head 110 of the actuator 108 is disposed in a cup 118 of the body 102 of the spacer 100 and the shaft 112 of the actuator extends into a cavity 119 defined by a casing 120 of the body 102. An actuator retainer 122 is coupled to the collar 111 of the actuator 108 between the flange 113 of the actuator and an outer surface of the casing 120 for retention of the remainder of the actuator in the body 102 of the spacer 100.

The cup 118 is coupled to a proximal end of the casing 120. In at least some embodiments, the cup 118 and casing 120 are formed together by, for example, molding. In other embodiments, the cup 118 is attached to the casing 120 by welding or any other suitable attachment technique. In at least some embodiments, the body 102 includes undercut notches 132 formed on opposite sides of the cup 118. In at least some embodiments, the notches 132 are configured for attachment of clamps 760 of a spacer insertion instrument 750, as described in below with respect to FIG. 7.

Pins 124 extend through pin openings 127 in the casing 120 of the body 120 and attach the arms 104, 106 to the casing. In at least some embodiments, the pins 124 are self-locking pins. Utilizing self-locking pins 124 and a can reduce the need for welding components of the spacer 100.

Each arm 104, 106 includes an attachment portion 126 with a tubular opening 127 for receiving one of the pins 124. Each of the attachment portions 126 extends into the casing 120 through an arm opening 128 in the casing so that each of the arms 104, 106 is rotatably coupled to the body 102 by one of the pins 124.

The arm 104 includes two extensions 104a, 104b coupled by a bridge 105 from which the attachment portion 126 extends. The arm 106 includes two extensions 106a, 106b coupled by a bridge 107 from which the attachment portion 126 extends. In the implantation position (see, FIG. 1), the extensions 104a, 104b, 106a, 106b extend adjacent the body 102 and back toward the cup 118 of the body and, at least in some embodiments, a portion of the extensions 104a, 104b, 106a, 106b extends beyond the cup 118 of the body 102 as illustrated in FIG. 1. In at least some embodiments, in the implantation position, a portion of the body 102 is disposed between extensions 104a, 104b and between extensions 106a, 106b. In at least some embodiments, in the implantation position, at least a portion of the bridges 105, 107 are disposed beneath ledges 121 formed by the casing 120 and cutouts 123 in the casing (see, FIG. 1 for an example of one embodiment of the spacer in the implantation position.) When the arms 104, 106 are deployed, as illustrated in FIG. 3, the pairs of extensions 104a, 140b, 106a, 106b extend away from the body 102 of the spacer 100 with the extensions of each pair disposed on opposing sides of one of the adjacent spinous processes.

Each of the attachment portions 126 of the arms 104, 106 includes a threaded surface 130 that engages (see, FIG. 5) the threads 114 on the shaft 112 of the actuator 108. The threads 114 on the shaft 112 of the actuator 108 act as a track for movement of the arms 104, 106 between the implantation position (FIG. 1) and the deployed position (FIG. 3). As the actuator 108 is rotated in a first direction (for example, clockwise), the arms 104, 106 deploy from the implantation position (see, FIG. 1) to the deployed position (see, FIG. 3). In at least some embodiments, as the actuator 108 is rotated in a second direction (for example, counterclockwise), the arms 104, 106 retract back toward the implantation position. In at least some embodiments, during deployment the arms 104, 106 synchronously deploy opposite each other. During deployment, the arms 104, 106 rotate dorsally and, at least in some embodiments, can cut or dissect tissue from the dorsal direction. In at least some embodiments, the dorsal deployment of the arms 104, 106 of the spacer 100 may be advantageous over the ventral deployment of arms of known spacers. In at least some embodiments, the deployment load is primarily applied by the head 110 of the actuator 108 acting against the cup 118 of the body 102.

In at least some embodiments, during deployment, the arms 104, 106 rotate through an arc of approximately 90 degrees with respect to the body 102 to the deployed position in which the extensions 104a, 104b, 106a, 106b of the arms are approximately perpendicular to the longitudinal axis of the body 102 as shown in FIG. 3. In at least some embodiments, the arms 104, 106 have a U-shaped projection in a plane perpendicular to the longitudinal axis of the body 102.

In at least some embodiments, the threaded surface 130 on the attachment portions 126 of each of the arms 104, 106 is bounded by one or more end stops 131a, 131b (FIG. 5) that preclude further rotation of the arms 104, 106. In at least some embodiments, the threaded surface 130 on the attachment portions 126 of each of the arms 104, 106 or the threads 114 on the shaft 112 of the actuator 108 (or any combination thereof) are selected to have a mechanical ratio (for example, a mechanical ratio of at least 10:1, 15:1, 20:1, 25:1, or more) that resists or prevents rotation of the arms 104, 106 by application of pressure or force against the arms. This can, for example, prevent or resist force applied to the arms by movement or the like from inadvertently rotating the arms 104, 106 after deployment.

In at least some embodiments, the length of the bridge 105 of the arm 104 is approximately 7 to 10 millimeters and the length of the bridge 107 of the arm 106 is approximately 5 to 8 millimeters. In at least some embodiments, the tip-to-tip distance of the extensions 104a, 104b is approximately 8 to 12 millimeters and the tip-to-tip distance of the extensions 106a, 106b is approximately 8 to 12 millimeters. In at least some embodiments, the arm 104 forms a larger space for receiving the superior spinous process than the space formed by the arm 106 for receiving the inferior spinous processes as spinous processes are naturally narrower on top and wider on the bottom.

U.S. Pat. Nos. 8,123,782; 8,128,662; 8,273,108; 8,277,488; 8,292,922; 8,425,559; 8,613,747; 8,864,828; 8,945,183; 9,119,680; 9,155,572; 9,161,783; 9,393,055; 9,532,812; 9,572,603; 9,861,398; 9,956,011; 10,080,587; 10,166,047; 10,610,267; 10,653,456; 10,835,295; 10,835,297; 11,013,539; and 11,229,461, all of which are incorporated herein by reference, illustrate a variety of tools for insertion and deployment of a spacer between adjacent spinous processes. These tools can be used or modified for insertion and deployment of the spacer 100 described above.

As an example, FIGS. 7 and 8 illustrate a spacer insertion instrument 750 and a driver tool 880, respectively. The spacer insertion instrument 750 includes a cannula 752 connected to a handle 754. The spacer insertion instrument 750 defines a central passageway 756 through the handle 754 and cannula 752. The driver tool 880 is removably insertable into the central passageway 756.

The cannula 752 includes clamps (for example, prongs) 760 to releasably clamp to the body 102 of the spacer 100 (for example, to the undercut notches 132 formed on opposite sides of the cup 118 of the body) for delivery of the spacer into the patient using the pacer insertion instrument 750. In at least some embodiments, the clamps 760 include extensions 761 that extend inwardly toward each other to form hooks. In at least some embodiments, the extensions 761 can engage the undercut notches 132 (FIG. 6) formed on opposite sides of the cup 118 of the body 102 of the spacer 100 to grip the spacer.

The cannula 752 also includes an inner shaft 762 (to which the clamps 760 are attached), an outer shaft 758, and a control 764. In at least some embodiments, the inner shaft 762 is connected to the handle 754 and the outer shaft 758 is passed over the inner shaft 762.

The outer shaft 758 translates with respect to the inner shaft 762 (or, alternatively, the inner shaft translates with respect to the outer shaft) using the control 764. The translation of the outer shaft 758 (or the inner shaft 762) operates the clamps 760. When the outer shaft 758 moves away from the clamps 760, the clamps separate to allow loading (or unloading) of the spacer 100 on the spacer insertion instrument 750. When the outer shaft 758 moves toward the clamps 760, the clamps are moved together to grip the spacer 100. For example, the clamps 760 can grip the undercut notches 132 formed on opposite sides of the cup 118 of the body 102 of the spacer 100. In this manner, the spacer insertion instrument 750 can hold the spacer 100 for delivery of the spacer into position between adjacent spinous processes within the patient.

Turning to FIG. 8, a driver tool 880 includes a handle 882 at the proximal end and a spacer engaging bit 884 at the distal end. The handle 882 and spacer engaging bit 884 are connected by a shaft 886. The driver tool 880 is sized to be inserted into the central passageway 756 of the spacer insertion instrument 750 such that the spacer engaging bit 884 at the distal end operatively connects with a spacer 100 gripped by the clamps 760 of the spacer insertion instrument 750. The spacer engaging bit 884 includes features for engaging with the shaped cavity 116 (see, FIG. 6) in the head 110 of the actuator 108 of the spacer 100. In at least some embodiments, the driver tool 880 has a spacer engaging bit 884 that is complementary to the shaped cavity 116 in the head 110 of the actuator 108 of the spacer 100. Rotating the driver tool 880 when engaged with the head 110 of the spacer 100 rotates the actuator 108 to deploy the arms 104, 106 of the spacer (or, in at least some embodiments, return the arms to the implantation position if rotated in the opposite direction.)

In at least some embodiments, a small midline or lateral-to-midline incision is made in the patient for percutaneous delivery of the spacer 100. In at least some embodiments, the supraspinous ligament is avoided. In at least some embodiments, the supraspinous ligament is split longitudinally along the direction of the tissue fibers to create an opening for the instrument. In at least some embodiments, one or more dilators may be used to create or enlarge the opening.

In at least some embodiments, the spacer 100, in the implantation state (see, FIG. 1), is releasably attached to the spacer insertion instrument 750 as described above. In at least some embodiments, the spacer 100 is inserted into a port or cannula, if one is employed, which has been operatively positioned to form an opening to the interspinous space within a patient's back. The spacer 100, attached to the spacer insertion instrument 750, is inserted into the interspinous space between the spinous processes of two adjacent vertebral bodies. In at least some embodiments, the spacer 100 is advanced beyond the end of a cannula or, alternatively, the cannula is pulled proximately to uncover the spacer 100 connected to the spacer insertion instrument 750. Once in position, the driver tool 880 is inserted into the spacer insertion instrument 750, if not previously inserted, to engage the actuator 108. The driver tool 880 is rotated to rotate the actuator 108. The rotating actuator 108 begins deployment of the arms 104, 106 of the spacer 100. Rotation in one direction, for example, clockwise, for example, deploys the arms 104, 106 through a partially deployed position (see, FIG. 2) to the deployed position (see, FIG. 3).

Other than the implantation position or deployed position, the arms 104, 106 of the spacer may be positioned in one of many partially deployed positions or intermediary positions. In at least some, embodiments, the deployment of the arms 104, 106 can be reversed by rotating the actuator 108 in the opposite direction, for example, counterclockwise.

In at least some embodiments, a clinician can observe with fluoroscopy or other imaging technique the positioning of the spacer 100 inside the patient and then choose to reposition the spacer 100 if desired. Repositioning of the spacer may involve reversing, or partially reversing, the deployment of the arms 104, 106. The arms 104, 106 of the spacer 100 may then be re-deployed into the desired location. This process can be repeated as necessary until the clinician has achieved the desired positioning of the spacer in the patient.

Following deployment of the spacer, the, the spacer insertion instrument 750 and driver tool 880 (and any other instrumentation, such as a cannula or dilator) is removed from the body of the patient. The spacer insertion instrument 750 can be operated as described above to release the clamps 760 from the spacer 100.

The above specification provides a description of the manufacture and use of the invention. Since many embodiments of the invention can be made without departing from the spirit and scope of the invention, the invention also resides in the claims hereinafter appended.

Claims

1. An interspinous spacer, comprising:

a body having a first pair of opposing, lateral, external sides, a second pair of opposing, lateral, external sides different from the first pair, a distal portion, and a proximal portion, wherein the body defines an opening on each side of the first pair of opposing, lateral, external sides;
an actuator at least partially disposed in the body;
a first arm and a second arm, wherein each of the first arm and the second arm comprises two extensions, a bridge coupling the two extensions together, and an attachment portion extending from the bridge, through the opening of a one of the sides of the first pair of opposing, lateral, external sides, toward the actuator, wherein the attachment portion is rotatably coupled to the body and engages the actuator, wherein the actuator, first arm, and second arm are configured, upon rotation of the actuator in a first direction, to rotate the first and second arms from an implantation position, in which the two extensions of each of the first arm and the second arm are external to a remainder of the interspinous spacer with a portion of each sides of the second pair of opposing, external, lateral sides of the body between the two extensions along a majority of a length of the two extensions, to a deployed position, in which the first and second arms extend away from the body;
a first pin rotatably coupling the first arm to the body; and
a second pin rotatably coupling the second arm to the body.

2. The interspinous spacer of claim 1, wherein the body comprises a cup and a casing attached to the cup, wherein the actuator comprises a head disposed in the cup and a shaft attached to the head and extending through the casing.

3. The interspinous spacer of claim 2, wherein the head of the actuator comprises a shaped cavity configured to receive a shaped spacer engaging bit of a driving tool for rotating the actuator, wherein a least a portion of the shaft of the actuator comprises threading.

4. The interspinous spacer of claim 3, wherein the attachment portion of each of the first arm and the second arm comprises a threaded surface configured for engagement with the threading of the shaft of the actuator.

5. The interspinous spacer of claim 2, further comprising an actuator retainer attached to an end of the shaft of the actuator outside of the casing.

6. The interspinous spacer of claim 2, wherein a least a portion of the shaft of the actuator comprises threading.

7. The interspinous spacer of claim 6, wherein the attachment portion of each of the first arm and the second arm comprises a threaded surface configured for engagement with the threading of the shaft of the actuator.

8. The interspinous spacer of claim 7, wherein each of the attachment portions further comprises at least one end stop bounding the threaded surface to resist further rotation of the respective first or second arm.

9. The interspinous spacer of claim 1, wherein, in the deployed position, the first arm is configured for receiving a first spinous process between the two extensions with the two extensions disposed on opposing sides of the first spinous process and the second arm is configured for receiving a second spinous process between the two extensions with the two extensions disposed on opposing sides of the second spinous process when the body is disposed between the first and second spinous processes.

10. The interspinous spacer of claim 1, wherein the first pin and the second pin are self-locking pins.

11. The interspinous spacer of claim 1, wherein

the first pin is positioned between the actuator and the bridge of the first arm and
the second pin is positioned between the actuator and the bridge of the second arm.

12. The interspinous spacer of claim 11, wherein the body comprises a cup and a casing attached to the cup, wherein the actuator comprises a head disposed in the cup and a shaft attached to the head and extending through the casing.

13. The interspinous spacer of claim 12, wherein the head of the actuator comprises a shaped cavity configured to receive a shaped spacer engaging bit of a driving tool for rotating the actuator.

14. The interspinous spacer of claim 1, wherein each of the first arm and the second arm are configured for rotation of at least 90 degrees.

15. The interspinous spacer of claim 1, wherein the actuator and each of the first arm and the second arm are configured for rotation in a first direction and then rotation in a second direction opposite the first direction.

16. The interspinous spacer of claim 11, wherein the first pin and the second pin are self-locking pins.

17. A method of using the interspinous spacer of claim 1, the method comprising;

releasably coupling the interspinous spacer in the implantation position to a spacer insertion instrument;
inserting the interspinous spacer coupled to the spacer insertion instrument into a patient and between a pair of adjacent spinous processes;
rotating the actuator of the interspinous spacer using a driver tool to rotate the first and second arms from an implantation position, in which the first and second arms are disposed adjacent to the body along a majority of a length of each of the first and second arms, to a deployed position, in which the first and second arms extend away from the body;
releasing the interspinous spacer from the spacer insertion instrument; and
removing the spacer insertion instrument.

18. A kit, comprising:

the interspinous spacer of claim 1;
a spacer insertion instrument configured to releasably grip the interspinous spacer for implantation into a patient; and
a driver tool comprising a spacer engaging bit configured to engage the actuator of the interspinous spacer and rotate the actuator by rotation of the driver tool.
Referenced Cited
U.S. Patent Documents
2248054 July 1941 Becker
2677369 May 1954 Knowles
2933114 April 1960 Bystrom
3242120 March 1966 Steuber
3486505 December 1969 Morrison
3648691 March 1972 Lumb et al.
3780733 December 1973 Martinez-Manzor
3986383 October 19, 1976 Petteys
4545374 October 8, 1985 Jacobson
4632101 December 30, 1986 Freeland
4685447 August 11, 1987 Iversen et al.
4799484 January 24, 1989 Smith et al.
4863476 September 5, 1989 Sheppard
4877020 October 31, 1989 Vich
4895564 January 23, 1990 Farrell
4986831 January 22, 1991 King et al.
5011484 April 30, 1991 Breard
5015247 May 14, 1991 Michelson
5019081 May 28, 1991 Watanabe
5040542 August 20, 1991 Gray
5059193 October 22, 1991 Kuslich
5092866 March 3, 1992 Breard et al.
5178628 January 12, 1993 Otsuka et al.
5180393 January 19, 1993 Commarmond
5182281 January 26, 1993 Frigola-Constansa et al.
5188281 February 23, 1993 Fujiwara et al.
5192281 March 9, 1993 de la Caffiniere
5195526 March 23, 1993 Michelson
5238295 August 24, 1993 Harrell
5298253 March 29, 1994 LeFiles et al.
5368594 November 29, 1994 Martin et al.
5390683 February 21, 1995 Pisharodi
5415661 May 16, 1995 Holmes
5456722 October 10, 1995 McLeod et al.
5462738 October 31, 1995 LeFiles et al.
5472452 December 5, 1995 Trott
5484437 January 16, 1996 Michelson
5487739 January 30, 1996 Aebischer et al.
5489308 February 6, 1996 Kuslich et al.
5496318 March 5, 1996 Howland et al.
5531748 July 2, 1996 de la Caffiniere
5549679 August 27, 1996 Kuslich
5571189 November 5, 1996 Kuslich
5591165 January 7, 1997 Jackson
5609634 March 11, 1997 Voydeville
5609636 March 11, 1997 Kohrs et al.
5645599 July 8, 1997 Samani
5654599 August 5, 1997 Casper
5658335 August 19, 1997 Allen
5658337 August 19, 1997 Kohrs et al.
5674295 October 7, 1997 Ray et al.
5700264 December 23, 1997 Zucherman et al.
5725582 March 10, 1998 Bevan et al.
5741253 April 21, 1998 Michelson
5746720 May 5, 1998 Stouder, Jr.
5762629 June 9, 1998 Kambin
5836948 November 17, 1998 Zucherman et al.
5860977 January 19, 1999 Zucherman et al.
5863948 January 26, 1999 Epstein et al.
5876404 March 2, 1999 Zucherman et al.
RE36211 May 18, 1999 Nonomura
5904636 May 18, 1999 Chen
5904686 May 18, 1999 Zucherman et al.
5928207 July 27, 1999 Pisano et al.
5948017 September 7, 1999 Taheri
5972015 October 26, 1999 Scribner et al.
6039761 March 21, 2000 Li et al.
6045552 April 4, 2000 Zucherman et al.
6048342 April 11, 2000 Zucherman et al.
6048345 April 11, 2000 Berke et al.
6066154 May 23, 2000 Reiley et al.
6068630 May 30, 2000 Zucherman et al.
6074390 June 13, 2000 Zucherman et al.
6080155 June 27, 2000 Michelson
6080157 June 27, 2000 Cathro et al.
6090112 July 18, 2000 Zucherman et al.
6096038 August 1, 2000 Michelson
6102928 August 15, 2000 Bonutti
6102950 August 15, 2000 Vaccaro
D433193 October 31, 2000 Gaw et al.
6132464 October 17, 2000 Martin
6149642 November 21, 2000 Gerhart et al.
6149652 November 21, 2000 Zucherman et al.
6152926 November 28, 2000 Zucherman et al.
6156038 December 5, 2000 Zucherman et al.
6159215 December 12, 2000 Urbahns et al.
6179873 January 30, 2001 Zientek
6183471 February 6, 2001 Zucherman et al.
6190387 February 20, 2001 Zucherman et al.
6225048 May 1, 2001 Soderberg-Naucler et al.
6235030 May 22, 2001 Zucherman et al.
6238397 May 29, 2001 Zucherman et al.
6264651 July 24, 2001 Underwood et al.
6264656 July 24, 2001 Michelson
6267763 July 31, 2001 Castro
6267765 July 31, 2001 Taylor et al.
6270498 August 7, 2001 Michelson
6280444 August 28, 2001 Zucherman et al.
6312431 November 6, 2001 Asfora
6328730 December 11, 2001 Harkrider, Jr.
6332882 December 25, 2001 Zucherman et al.
6332883 December 25, 2001 Zucherman et al.
6336930 January 8, 2002 Stalcup et al.
6348053 February 19, 2002 Cachia
6364883 April 2, 2002 Santilli
6371989 April 16, 2002 Chauvin et al.
6375682 April 23, 2002 Fleischmann et al.
6379355 April 30, 2002 Zucherman et al.
6387130 May 14, 2002 Stone et al.
6395032 May 28, 2002 Gauchet
6402740 June 11, 2002 Ellis et al.
6402750 June 11, 2002 Atkinson et al.
6402784 June 11, 2002 Wardlaw
6413228 July 2, 2002 Hung et al.
6419676 July 16, 2002 Zucherman et al.
6419677 July 16, 2002 Zucherman et al.
6440169 August 27, 2002 Elberg et al.
6443988 September 3, 2002 Felt et al.
6447547 September 10, 2002 Michelson
6451019 September 17, 2002 Zucherman et al.
6451020 September 17, 2002 Zucherman et al.
6464682 October 15, 2002 Snoke
6471976 October 29, 2002 Taylor et al.
6478796 November 12, 2002 Zucherman et al.
6478822 November 12, 2002 Leroux et al.
6500178 December 31, 2002 Zucherman et al.
6514256 February 4, 2003 Zucherman et al.
6530925 March 11, 2003 Boudard et al.
6558333 May 6, 2003 Gilboa et al.
6565570 May 20, 2003 Sterett et al.
6572617 June 3, 2003 Senegas
6575981 June 10, 2003 Boyd et al.
6579281 June 17, 2003 Palmer et al.
6579319 June 17, 2003 Goble et al.
6582433 June 24, 2003 Yun
6582451 June 24, 2003 Marucci et al.
6599292 July 29, 2003 Ray
6602248 August 5, 2003 Sharps et al.
6610065 August 26, 2003 Branch et al.
6610091 August 26, 2003 Reiley
6616673 September 9, 2003 Stone et al.
6626944 September 30, 2003 Taylor
6645207 November 11, 2003 Dixon et al.
6645211 November 11, 2003 Magana
6652527 November 25, 2003 Zucherman et al.
6652534 November 25, 2003 Zucherman et al.
6663637 December 16, 2003 Dixon et al.
6679886 January 20, 2004 Weikel et al.
6695842 February 24, 2004 Zucherman et al.
6699246 March 2, 2004 Zucherman et al.
6699247 March 2, 2004 Zucherman et al.
6702847 March 9, 2004 Dicarlo
6712819 March 30, 2004 Zucherman et al.
6716215 April 6, 2004 David et al.
6716245 April 6, 2004 Pasquel et al.
6726690 April 27, 2004 Eckman
6733534 May 11, 2004 Sherman
6746485 June 8, 2004 Zucherman et al.
6761720 July 13, 2004 Senegas
6783529 August 31, 2004 Hover et al.
6783546 August 31, 2004 Zucherman et al.
6796983 September 28, 2004 Zucherman et al.
6805697 October 19, 2004 Helm et al.
6835205 December 28, 2004 Atkinson et al.
6840944 January 11, 2005 Suddaby
6858029 February 22, 2005 Yeh
6869398 March 22, 2005 Obenchain et al.
6875212 April 5, 2005 Shaolian et al.
6902566 June 7, 2005 Zucherman et al.
6926728 August 9, 2005 Zucherman et al.
6946000 September 20, 2005 Senegas et al.
6949123 September 27, 2005 Reiley
6966930 November 22, 2005 Amin et al.
6974478 December 13, 2005 Reiley et al.
6976988 December 20, 2005 Ralph et al.
7011685 March 14, 2006 Arnin et al.
7029473 April 18, 2006 Zucherman et al.
7033358 April 25, 2006 Taylor et al.
7048736 May 23, 2006 Robinson et al.
7070598 July 4, 2006 Lim et al.
7083649 August 1, 2006 Zucherman et al.
7087055 August 8, 2006 Lim et al.
7087083 August 8, 2006 Pasquel et al.
7097648 August 29, 2006 Globerman et al.
7101375 September 5, 2006 Zucherman et al.
7163558 January 16, 2007 Senegas et al.
7179225 February 20, 2007 Shluzas et al.
7189234 March 13, 2007 Zucherman et al.
7189236 March 13, 2007 Taylor et al.
7201751 April 10, 2007 Zucherman et al.
7217291 May 15, 2007 Zucherman et al.
7223289 May 29, 2007 Trieu et al.
7187064 March 6, 2007 Matge et al.
7229441 June 12, 2007 Trieu et al.
7238204 July 3, 2007 Le Couedic et al.
7252673 August 7, 2007 Lim
7273496 September 25, 2007 Mitchell
7282063 October 16, 2007 Cohen et al.
7297162 November 20, 2007 Mujwid
7306628 December 11, 2007 Zucherman et al.
7318839 January 15, 2008 Malberg et al.
7320707 January 22, 2008 Zucherman et al.
7335200 February 26, 2008 Carli
7335203 February 26, 2008 Winslow et al.
7354453 April 8, 2008 McAfee
7384340 June 10, 2008 Eguchi et al.
7390330 June 24, 2008 Harp
7410501 August 12, 2008 Michelson
7442208 October 28, 2008 Mathieu et al.
7445637 November 4, 2008 Taylor
7473268 January 6, 2009 Zucherman et al.
7476251 January 13, 2009 Zucherman et al.
7481839 January 27, 2009 Zucherman et al.
7481840 January 27, 2009 Zucherman et al.
7491204 February 17, 2009 Marnay et al.
7497859 March 3, 2009 Zucherman et al.
7503935 March 17, 2009 Zucherman et al.
7504798 March 17, 2009 Kawada et al.
7510567 March 31, 2009 Zucherman et al.
7520887 April 21, 2009 Maxy et al.
7520899 April 21, 2009 Zucherman et al.
7547308 June 16, 2009 Bertagnoli et al.
7549999 June 23, 2009 Zucherman et al.
7550009 June 23, 2009 Amin et al.
7565259 July 21, 2009 Sheng et al.
7572276 August 11, 2009 Lim et al.
7575600 August 18, 2009 Zucherman et al.
7585313 September 8, 2009 Kwak et al.
7585316 September 8, 2009 Trieu
7588588 September 15, 2009 Spitler et al.
7591851 September 22, 2009 Winslow et al.
7601170 October 13, 2009 Winslow et al.
7621939 November 24, 2009 Zucherman et al.
7635377 December 22, 2009 Zucherman et al.
7635378 December 22, 2009 Zucherman et al.
7637950 December 29, 2009 Baccelli et al.
7658752 February 9, 2010 Labrom et al.
7662187 February 16, 2010 Zucherman et al.
7666186 February 23, 2010 Harp
7666209 February 23, 2010 Zucherman et al.
7666228 February 23, 2010 Le Couedic et al.
7670377 March 2, 2010 Zucherman et al.
7682376 March 23, 2010 Trieu
7691146 April 6, 2010 Zucherman et al.
7695513 April 13, 2010 Zucherman et al.
7699852 April 20, 2010 Frankel et al.
7699873 April 20, 2010 Stevenson et al.
D618796 June 29, 2010 Cantu
7727233 June 1, 2010 Blackwell et al.
7727241 June 1, 2010 Gorensek et al.
7731751 June 8, 2010 Butler et al.
7742795 June 22, 2010 Stone et al.
7749231 July 6, 2010 Bonvallet et al.
7749252 July 6, 2010 Zucherman et al.
7749253 July 6, 2010 Zucherman et al.
7753938 July 13, 2010 Aschmann et al.
7758619 July 20, 2010 Zucherman et al.
7758647 July 20, 2010 Amin et al.
7763028 July 27, 2010 Lim et al.
7763050 July 27, 2010 Winslow et al.
7763051 July 27, 2010 Labrom et al.
7763073 July 27, 2010 Hawkins et al.
7763074 July 27, 2010 Altarac et al.
7766967 August 3, 2010 Francis
7776090 August 17, 2010 Winslow et al.
7780709 August 24, 2010 Bruneau et al.
7789898 September 7, 2010 Peterman
7794476 September 14, 2010 Wisnewski
7803190 September 28, 2010 Zucherman et al.
7806911 October 5, 2010 Peckham
7811308 October 12, 2010 Amin et al.
7811322 October 12, 2010 Amin et al.
7811323 October 12, 2010 Amin et al.
7811324 October 12, 2010 Amin et al.
7811330 October 12, 2010 Amin et al.
7819921 October 26, 2010 Grotz
7828822 November 9, 2010 Zucherman et al.
7828849 November 9, 2010 Lim
7833272 November 16, 2010 Amin et al.
7837687 November 23, 2010 Harp
7837688 November 23, 2010 Boyer et al.
7837700 November 23, 2010 Harp
7837711 November 23, 2010 Bruneau et al.
7837734 November 23, 2010 Zucherman et al.
7846183 December 7, 2010 Blain
7846185 December 7, 2010 Carls et al.
7846186 December 7, 2010 Taylor
7857815 December 28, 2010 Zucherman et al.
7862569 January 4, 2011 Zucherman et al.
7862586 January 4, 2011 Malek
7862590 January 4, 2011 Lim et al.
7862592 January 4, 2011 Peterson et al.
7862615 January 4, 2011 Carli et al.
7867276 January 11, 2011 Matge et al.
7871426 January 18, 2011 Chin et al.
7896879 March 1, 2011 Solsberg et al.
7942830 May 17, 2011 Solsberg et al.
7955392 June 7, 2011 Dewey et al.
7985246 July 26, 2011 Trieu et al.
8012207 September 6, 2011 Kim
8025684 September 27, 2011 Garcia-Bengochea et al.
8057513 November 15, 2011 Kohm et al.
8062332 November 22, 2011 Cunningham et al.
8100823 January 24, 2012 Harp
8123782 February 28, 2012 Altarac et al.
8123807 February 28, 2012 Kim
8128662 March 6, 2012 Altarac et al.
8152837 April 10, 2012 Altarac et al.
8167944 May 1, 2012 Kim
8226690 July 24, 2012 Altarac et al.
8273108 September 25, 2012 Altarac et al.
8277488 October 2, 2012 Altarac et al.
8292922 October 23, 2012 Altarac et al.
8317864 November 27, 2012 Kim
8409282 April 2, 2013 Kim
8425559 April 23, 2013 Tebbe et al.
8608762 December 17, 2013 Solsberg et al.
8613747 December 24, 2013 Altarac et al.
8628574 January 14, 2014 Altarac et al.
8696671 April 15, 2014 Solsberg et al.
8734477 May 27, 2014 Solsberg et al.
8740948 June 3, 2014 Reglos et al.
8845726 September 30, 2014 Tebbe et al.
8864828 October 21, 2014 Altarac et al.
8882772 November 11, 2014 Solsberg et al.
8894653 November 25, 2014 Solsberg et al.
8900271 December 2, 2014 Kim
8945183 February 3, 2015 Altarac et al.
9023084 May 5, 2015 Kim
9039742 May 26, 2015 Altarac et al.
9119680 September 1, 2015 Altarac et al.
9125692 September 8, 2015 Kim
9155570 October 13, 2015 Altarac et al.
9155572 October 13, 2015 Altarac et al.
9161783 October 20, 2015 Altarac et al.
9186186 November 17, 2015 Reglos et al.
9211146 December 15, 2015 Kim
9283005 March 15, 2016 Tebbe et al.
9314279 April 19, 2016 Kim
9393055 July 19, 2016 Altarac et al.
9445843 September 20, 2016 Altarac et al.
9532812 January 3, 2017 Altarac et al.
9572603 February 21, 2017 Altarac et al.
9675303 June 13, 2017 Choi
9861398 January 9, 2018 Altarac et al.
9956011 May 1, 2018 Altarac et al.
10058358 August 28, 2018 Altarac et al.
10080587 September 25, 2018 Altarac et al.
10166047 January 1, 2019 Altarac et al.
10258479 April 16, 2019 Stewart et al.
10524772 January 7, 2020 Choi et al.
10610267 April 7, 2020 Altarac et al.
10653456 May 19, 2020 Altarac et al.
10835295 November 17, 2020 Altarac et al.
10835297 November 17, 2020 Altarac et al.
11013539 May 25, 2021 Altarac et al.
11229461 January 25, 2022 Altarac et al.
20010031965 October 18, 2001 Zucherman et al.
20020022856 February 21, 2002 Johnson et al.
20020042607 April 11, 2002 Palmer et al.
20020116009 August 22, 2002 Fraser et al.
20020143331 October 3, 2002 Zucherman et al.
20020151977 October 17, 2002 Paes et al.
20030040746 February 27, 2003 Mitchell et al.
20030040753 February 27, 2003 Daum et al.
20030074075 April 17, 2003 Thomas et al.
20030105466 June 5, 2003 Ralph et al.
20030135275 July 17, 2003 Garcia et al.
20030149438 August 7, 2003 Nichols et al.
20030153976 August 14, 2003 Cauthen, III et al.
20030176921 September 18, 2003 Lawson
20030220643 November 27, 2003 Ferree
20030220650 November 27, 2003 Major et al.
20030233098 December 18, 2003 Markworth
20040087947 May 6, 2004 Lim et al.
20040106997 June 3, 2004 Lieberson
20040106999 June 3, 2004 Mathews
20040148028 July 29, 2004 Ferree et al.
20040167625 August 26, 2004 Beyar et al.
20040220568 November 4, 2004 Zucherman et al.
20040225295 November 11, 2004 Zubok et al.
20040260305 December 23, 2004 Gorensek et al.
20050021042 January 27, 2005 Marnay et al.
20050049708 March 3, 2005 Atkinson et al.
20050075634 April 7, 2005 Zucherman et al.
20050090822 April 28, 2005 DiPoto
20050101955 May 12, 2005 Zucherman et al.
20050125066 June 9, 2005 McAfee
20050143738 June 30, 2005 Zucherman et al.
20050165398 July 28, 2005 Reiley
20050192586 September 1, 2005 Zucherman et al.
20050192671 September 1, 2005 Bao et al.
20050209603 September 22, 2005 Zucherman et al.
20050209698 September 22, 2005 Gordon
20050216087 September 29, 2005 Zucherman et al.
20050228383 October 13, 2005 Zucherman et al.
20050228384 October 13, 2005 Zucherman et al.
20050228426 October 13, 2005 Campbell
20050245937 November 3, 2005 Winslow
20050278036 December 15, 2005 Leonard et al.
20060030860 February 9, 2006 Peterman
20060036258 February 16, 2006 Zucherman et al.
20060064107 March 23, 2006 Bertagnoli et al.
20060064165 March 23, 2006 Zucherman et al.
20060064166 March 23, 2006 Zucherman et al.
20060074431 April 6, 2006 Sutton et al.
20060084976 April 20, 2006 Borgstrom et al.
20060084983 April 20, 2006 Kim
20060084985 April 20, 2006 Kim
20060084988 April 20, 2006 Kim
20060084991 April 20, 2006 Borgstrom et al.
20060085069 April 20, 2006 Kim
20060085070 April 20, 2006 Kim
20060085074 April 20, 2006 Raiszadeh
20060089718 April 27, 2006 Zucherman et al.
20060122458 June 8, 2006 Bleich
20060122620 June 8, 2006 Kim
20060149254 July 6, 2006 Lauryssen et al.
20060149289 July 6, 2006 Winslow et al.
20060167416 July 27, 2006 Mathis et al.
20060195102 August 31, 2006 Malandain
20060217811 September 28, 2006 Lambrecht et al.
20060224159 October 5, 2006 Anderson
20060235386 October 19, 2006 Anderson
20060241597 October 26, 2006 Mitchell et al.
20060241614 October 26, 2006 Bruneau et al.
20060241757 October 26, 2006 Anderson
20060247623 November 2, 2006 Anderson et al.
20060247632 November 2, 2006 Winslow et al.
20060247633 November 2, 2006 Winslow et al.
20060247650 November 2, 2006 Yerby et al.
20060247773 November 2, 2006 Stamp
20060264938 November 23, 2006 Zucherman et al.
20060264939 November 23, 2006 Zucherman et al.
20060265066 November 23, 2006 Zucherman et al.
20060265067 November 23, 2006 Zucherman et al.
20060271044 November 30, 2006 Petrini et al.
20060271049 November 30, 2006 Zucherman et al.
20060271055 November 30, 2006 Thramann
20060271061 November 30, 2006 Beyar et al.
20060271194 November 30, 2006 Zucherman et al.
20060276801 December 7, 2006 Yerby et al.
20060276897 December 7, 2006 Winslow et al.
20060282077 December 14, 2006 Labrom et al.
20060282078 December 14, 2006 Labrom et al.
20070016196 January 18, 2007 Winslow et al.
20070032790 February 8, 2007 Aschmann et al.
20070055237 March 8, 2007 Edidin et al.
20070055246 March 8, 2007 Zucherman et al.
20070073289 March 29, 2007 Kwak et al.
20070073292 March 29, 2007 Kohm et al.
20070100340 May 3, 2007 Lange et al.
20070100366 May 3, 2007 Dziedzic et al.
20070123863 May 31, 2007 Winslow et al.
20070123904 May 31, 2007 Stad et al.
20070161991 July 12, 2007 Altarac et al.
20070161993 July 12, 2007 Lowery et al.
20070173818 July 26, 2007 Hestad et al.
20070173821 July 26, 2007 Trieu
20070173822 July 26, 2007 Bruneau et al.
20070173823 July 26, 2007 Dewey et al.
20070173832 July 26, 2007 Tebbe et al.
20070173939 July 26, 2007 Kim et al.
20070179500 August 2, 2007 Chin et al.
20070185490 August 9, 2007 Implicito
20070191857 August 16, 2007 Allard et al.
20070191948 August 16, 2007 Amin et al.
20070191991 August 16, 2007 Addink
20070198045 August 23, 2007 Morton et al.
20070198091 August 23, 2007 Boyer et al.
20070203493 August 30, 2007 Zucherman et al.
20070203495 August 30, 2007 Zucherman et al.
20070203496 August 30, 2007 Zucherman et al.
20070203497 August 30, 2007 Zucherman et al.
20070203501 August 30, 2007 Zucherman et al.
20070208345 September 6, 2007 Marnay et al.
20070208346 September 6, 2007 Marnay et al.
20070208366 September 6, 2007 Pellegrino et al.
20070210018 September 13, 2007 Wallwiener et al.
20070225706 September 27, 2007 Clark et al.
20070225724 September 27, 2007 Edmond
20070225807 September 27, 2007 Phan et al.
20070225814 September 27, 2007 Atkinson et al.
20070233068 October 4, 2007 Bruneau et al.
20070233074 October 4, 2007 Anderson et al.
20070233076 October 4, 2007 Trieu
20070233077 October 4, 2007 Khalili
20070233081 October 4, 2007 Pasquel et al.
20070233082 October 4, 2007 Chin et al.
20070233083 October 4, 2007 Abdou
20070233084 October 4, 2007 Betz et al.
20070233088 October 4, 2007 Edmond
20070233089 October 4, 2007 DiPoto et al.
20070233096 October 4, 2007 Garcia-Bengochea
20070233098 October 4, 2007 Mastrorio et al.
20070233129 October 4, 2007 Bertagnoli et al.
20070250060 October 25, 2007 Anderson et al.
20070260245 November 8, 2007 Malandain et al.
20070265623 November 15, 2007 Malandain et al.
20070265624 November 15, 2007 Zucherman et al.
20070265625 November 15, 2007 Zucherman et al.
20070265626 November 15, 2007 Seme
20070270822 November 22, 2007 Heinz
20070270823 November 22, 2007 Trieu et al.
20070270824 November 22, 2007 Lim et al.
20070270826 November 22, 2007 Trieu et al.
20070270827 November 22, 2007 Lim et al.
20070270828 November 22, 2007 Bruneau et al.
20070270829 November 22, 2007 Carls et al.
20070270834 November 22, 2007 Bruneau et al.
20070272259 November 29, 2007 Allard et al.
20070276368 November 29, 2007 Trieu et al.
20070276369 November 29, 2007 Allard et al.
20070276370 November 29, 2007 Altarac et al.
20070276372 November 29, 2007 Malandain et al.
20070276373 November 29, 2007 Malandain
20070276390 November 29, 2007 Salsberg
20070276493 November 29, 2007 Malandain et al.
20070276496 November 29, 2007 Lange et al.
20070276497 November 29, 2007 Anderson
20070276500 November 29, 2007 Zucherman et al.
20080015700 January 17, 2008 Zucherman et al.
20080021468 January 24, 2008 Zucherman et al.
20080021560 January 24, 2008 Zucherman et al.
20080021561 January 24, 2008 Zucherman et al.
20080027545 January 31, 2008 Zucherman et al.
20080027552 January 31, 2008 Zucherman et al.
20080027553 January 31, 2008 Zucherman et al.
20080033445 February 7, 2008 Zucherman et al.
20080033553 February 7, 2008 Zucherman et al.
20080033558 February 7, 2008 Zucherman et al.
20080033559 February 7, 2008 Zucherman et al.
20080039853 February 14, 2008 Zucherman et al.
20080039858 February 14, 2008 Zucherman et al.
20080039859 February 14, 2008 Zucherman et al.
20080039945 February 14, 2008 Zucherman et al.
20080039946 February 14, 2008 Zucherman et al.
20080039947 February 14, 2008 Zucherman et al.
20080045958 February 21, 2008 Zucherman et al.
20080045959 February 21, 2008 Zucherman et al.
20080046081 February 21, 2008 Zucherman et al.
20080046085 February 21, 2008 Zucherman et al.
20080046086 February 21, 2008 Zucherman et al.
20080046087 February 21, 2008 Zucherman et al.
20080046088 February 21, 2008 Zucherman et al.
20080051785 February 28, 2008 Zucherman et al.
20080051896 February 28, 2008 Suddaby
20080051898 February 28, 2008 Zucherman et al.
20080051899 February 28, 2008 Zucherman et al.
20080051904 February 28, 2008 Zucherman et al.
20080051905 February 28, 2008 Zucherman et al.
20080058806 March 6, 2008 Klyce et al.
20080058807 March 6, 2008 Klyce et al.
20080058808 March 6, 2008 Klyce et al.
20080058941 March 6, 2008 Zucherman et al.
20080065086 March 13, 2008 Zucherman et al.
20080065212 March 13, 2008 Zucherman et al.
20080065213 March 13, 2008 Zucherman et al.
20080065214 March 13, 2008 Zucherman et al.
20080071280 March 20, 2008 Winslow
20080071378 March 20, 2008 Zucherman et al.
20080071380 March 20, 2008 Sweeney
20080086212 April 10, 2008 Zucherman et al.
20080108990 May 8, 2008 Mitchell et al.
20080114455 May 15, 2008 Lange et al.
20080132952 June 5, 2008 Malandain et al.
20080167655 July 10, 2008 Wang et al.
20080167656 July 10, 2008 Zucherman et al.
20080167657 July 10, 2008 Greenhalgh
20080172057 July 17, 2008 Zucherman et al.
20080177271 July 24, 2008 Yeh
20080177272 July 24, 2008 Zucherman et al.
20080177306 July 24, 2008 Lamborne et al.
20080177312 July 24, 2008 Perez-Cruet et al.
20080183210 July 31, 2008 Zucherman et al.
20080188895 August 7, 2008 Cragg et al.
20080195152 August 14, 2008 Altarac
20080208344 August 28, 2008 Kilpela et al.
20080215058 September 4, 2008 Zucherman et al.
20080221692 September 11, 2008 Zucherman et al.
20080228225 September 18, 2008 Trautwein et al.
20080234708 September 25, 2008 Houser et al.
20080234824 September 25, 2008 Youssef et al.
20080287997 November 20, 2008 Altarac et al.
20080288075 November 20, 2008 Zucherman et al.
20080319550 December 25, 2008 Altarac et al.
20090012528 January 8, 2009 Aschmann et al.
20090118833 May 7, 2009 Hudgins et al.
20090125030 May 14, 2009 Tebbe et al.
20090125036 May 14, 2009 Bleich
20090138046 May 28, 2009 Altarac et al.
20090138055 May 28, 2009 Altarac et al.
20090222043 September 3, 2009 Altarac et al.
20090248079 October 1, 2009 Kwak et al.
20090292315 November 26, 2009 Trieu
20090292316 November 26, 2009 Hess
20100042217 February 18, 2010 Zucherman et al.
20100082108 April 1, 2010 Zucherman et al.
20100114100 May 6, 2010 Mehdizade
20100131009 May 27, 2010 Roebling et al.
20100152775 June 17, 2010 Seifert
20100160947 June 24, 2010 Akyuz et al.
20100228092 September 9, 2010 Ortiz et al.
20100234889 September 16, 2010 Hess
20100262243 October 14, 2010 Zucherman et al.
20100280551 November 4, 2010 Pool
20100305611 December 2, 2010 Zucherman et al.
20110172710 July 14, 2011 Thommen
20110245833 October 6, 2011 Anderson
20110313457 December 22, 2011 Reglos et al.
20120078301 March 29, 2012 Hess
20120158063 June 21, 2012 Altarac et al.
20120226315 September 6, 2012 Altarac et al.
20120232552 September 13, 2012 Morgenstern Lopez et al.
20120303039 November 29, 2012 Chin et al.
20120330359 December 27, 2012 Kim
20130012998 January 10, 2013 Altarac et al.
20130072985 March 21, 2013 Kim
20130165974 June 27, 2013 Kim
20130165975 June 27, 2013 Tebbe et al.
20130172932 July 4, 2013 Altarac et al.
20130172933 July 4, 2013 Altarac et al.
20130289399 October 31, 2013 Choi et al.
20130289622 October 31, 2013 Kim
20140081332 March 20, 2014 Altarac et al.
20140214082 July 31, 2014 Reglos et al.
20150150598 June 4, 2015 Tebbe et al.
20150150604 June 4, 2015 Kim
20150374415 December 31, 2015 Kim
20160030092 February 4, 2016 Altarac et al.
20160066963 March 10, 2016 Kim
20160317193 November 3, 2016 Kim
20170071588 March 16, 2017 Choi et al.
20170128110 May 11, 2017 Altarac et al.
20170156763 June 8, 2017 Altarac et al.
20170245883 August 31, 2017 Tebbe et al.
20170258501 September 14, 2017 Altarac et al.
20170273722 September 28, 2017 Altarac et al.
20170296238 October 19, 2017 Snell et al.
20170348028 December 7, 2017 Calvosa
20180028130 February 1, 2018 Choi
20180193064 July 12, 2018 Kim
20180228519 August 16, 2018 Altarac et al.
20190069933 March 7, 2019 Altarac et al.
20190090912 March 28, 2019 Altarac et al.
20190090913 March 28, 2019 Altarac et al.
20190105082 April 11, 2019 Altarac et al.
20190105083 April 11, 2019 Kim
20190201057 July 4, 2019 Altarac et al.
20230240726 August 3, 2023 Linares
Foreign Patent Documents
268461 February 1927 CA
2794456 July 2006 CN
101897603 December 2010 CN
322334 June 1989 EP
0767636 January 1999 EP
0768843 February 1999 EP
1138268 October 2001 EP
1056408 December 2003 EP
1343424 September 2004 EP
1454589 September 2004 EP
1330987 March 2005 EP
1299042 March 2006 EP
1578314 May 2007 EP
1675535 May 2007 EP
0959792 November 2007 EP
1027004 December 2007 EP
1030615 December 2007 EP
1570793 May 2008 EP
1148850 April 2009 EP
1861046 February 2012 EP
2681525 March 1993 FR
2717675 May 1996 FR
2722980 September 1996 FR
2816197 May 2002 FR
988281 January 1983 SU
WO9404088 March 1994 WO
WO9426192 November 1994 WO
WO9525485 September 1995 WO
WO9531158 November 1995 WO
WO9600049 January 1996 WO
WO9829047 July 1998 WO
WO9921500 May 1999 WO
WO9921501 May 1999 WO
WO9942051 August 1999 WO
WO0013619 March 2000 WO
WO0044319 August 2000 WO
WO0044321 August 2000 WO
WO0128442 April 2001 WO
WO0191657 December 2001 WO
WO0191658 December 2001 WO
WO0203882 January 2002 WO
WO0207623 January 2002 WO
WO0207624 January 2002 WO
WO02051326 July 2002 WO
WO02067793 September 2002 WO
WO02071960 September 2002 WO
WO02076336 October 2002 WO
WO03007791 January 2003 WO
WO03007829 January 2003 WO
WO03008016 January 2003 WO
WO03015646 February 2003 WO
WO03024298 March 2003 WO
WO03045262 June 2003 WO
WO03099147 December 2003 WO
WO03101350 December 2003 WO
WO04073533 September 2004 WO
WO04110300 December 2004 WO
WO05009300 February 2005 WO
WO05013839 February 2005 WO
WO05025461 March 2005 WO
WO05041799 May 2005 WO
WO05044152 May 2005 WO
WO05055868 June 2005 WO
WO05079672 September 2005 WO
WO2005086776 September 2005 WO
WO05115261 December 2005 WO
WO06033659 March 2006 WO
WO06034423 March 2006 WO
WO06039243 April 2006 WO
WO06039260 April 2006 WO
WO06045094 April 2006 WO
WO06063047 June 2006 WO
WO06065774 June 2006 WO
WO2006064356 June 2006 WO
WO2006089085 August 2006 WO
WO06102269 September 2006 WO
WO06102428 September 2006 WO
WO06102485 September 2006 WO
WO06107539 October 2006 WO
WO06110462 October 2006 WO
WO06110464 October 2006 WO
WO06110767 October 2006 WO
WO06113080 October 2006 WO
WO06113406 October 2006 WO
WO06113814 October 2006 WO
WO2006106246 October 2006 WO
WO06118945 November 2006 WO
WO06119235 November 2006 WO
WO06119236 November 2006 WO
WO06135511 December 2006 WO
WO2007010140 January 2007 WO
WO07015028 February 2007 WO
WO07035120 March 2007 WO
WO07075375 July 2007 WO
WO07075788 July 2007 WO
WO07075791 July 2007 WO
WO07089605 August 2007 WO
WO07089905 August 2007 WO
WO07089975 August 2007 WO
WO07097735 August 2007 WO
WO07109402 September 2007 WO
WO07110604 October 2007 WO
WO07111795 October 2007 WO
WO07111979 October 2007 WO
WO07111999 October 2007 WO
WO07117882 October 2007 WO
WO07121070 October 2007 WO
WO07127550 November 2007 WO
WO07127588 November 2007 WO
WO07127677 November 2007 WO
WO07127689 November 2007 WO
WO07127694 November 2007 WO
WO07127734 November 2007 WO
WO07127736 November 2007 WO
WO07131165 November 2007 WO
WO07134113 November 2007 WO
WO2008009049 January 2008 WO
WO08048645 April 2008 WO
WO2008057506 May 2008 WO
WO2008130564 October 2008 WO
WO2009014728 January 2009 WO
WO2009033093 March 2009 WO
WO2009083276 July 2009 WO
WO-2009083583 July 2009 WO
WO2009086010 July 2009 WO
WO2009091922 July 2009 WO
WO2009094463 July 2009 WO
WO2009114479 September 2009 WO
WO2011084477 July 2011 WO
WO2015171814 November 2015 WO
Other references
  • ASNR Neuroradiology Patient Information website, Brain and Spine Imaging: A Patient's Guide to Neuroradiology; Myelography; http://www.asnr.org/patientinfo/procedures/myelography.shtml#/sthash.sXIDOxWq.dpbs, Copyright 2012-2013.
  • Choi, Gun et al., “Percutaneous Endoscopic Interlaminar Disectomy for Intracanalicular Disc Herniations at L5-S1 Using a Rigid Working Channel Endoscope,” Operative Neurosurg., 58: pp. 59-68 (2006).
  • Fast, Avital et al., “Surgical Treatment of Lumbar Spinal Stenosis in the Elderly,” Arch Phys. Med Rehabil., Mar. 1985, pp. 149-151, vol. 66.
  • Lee, Seungcheol et al., “New Surgical Techniques of Percutaneous Endoscopic Lumbar Disectomy for Migrated Disc Herniation,” Joint Dis. Rel. Surg., 16(2); pp. 102-110 (2005).
  • Lee, Seungcheol et al., “Percutaneous Endoscopic Interlaminar Disectomy for L5-S1 Disc Herniation: Axillary Approach and Preliminary Results,” J. of Korean Neurosurg. Soc., 40: pp. 79-83 (2006).
  • Mcculloch, John A., Young, Paul H., “Essentials of Spinal Microsurgery,” 1998, pp. 453-485. Lippincott-Raven Publishers, Philadelphia, PA (37 pages total).
  • Minns, R.J., et al., “Preliminary Design and Experimental Studies of a Noval Soft Implant for Correcting Sagittal Plane Instability in the Lumbar Spine,” (1997) Spine, 22(16): 1819-1825.
  • Palmer, Sylvain et al., “Bilateral decompressive surgery in lumbar spinal stenosis associated with spondylolisthesis: unilateral approach and use of a microscope and tubular retractor system,” Neurosurgery Focus, Jul. 2002, pp. 1-6, vol. 13.
  • Swan, Colby, “Point of View: Preliminary Design and Experimental Studies of a Novel Soft Implant for Correcting Sogittal Plane Instability in the Lumbar Spine,” Spine, 1997, 22(16), 1826-1827.
  • Tredway, Trent L. et al., “Minimally Invasive Transforaminal Lumbar Interbody Fusion (MI-TLIF) and Lateral Mass Fusion with the MetRx System,” (14 pages total), 2005.
  • Vaccaro, Alexander J. et al., MasterCases Spine Surgery, 2001, pp. 100-107. Thieme Medical Publishers, Inc., NY. (10 pages total).
  • Vertos mild Devices Kit—PRT-00430-C—Instructions for Use (13 pages total); see http://vertosmed.com/docs/mild1FU_PRT-00430-C.pdf., 2012.
  • International Search Report and Written Opinion for PCT Application No. PCT/US2023/012635 mailed Jun. 2, 2023.
Patent History
Patent number: 12102542
Type: Grant
Filed: Feb 8, 2023
Date of Patent: Oct 1, 2024
Patent Publication Number: 20230255786
Assignee: Boston Scientific Neuromodulation Corporation (Valencia, CA)
Inventor: Yu-min Lin (Valencia, CA)
Primary Examiner: Jan Christoher L Merene
Application Number: 18/107,376
Classifications
Current U.S. Class: Headrest (297/391)
International Classification: A61F 2/44 (20060101); A61F 2/46 (20060101); A61F 2/30 (20060101);